Social engineering? The striking similarities between health reform and Prohibition

Every weekend, New York on the Potomac hares with you the best work of some of Hearst Newspapers’ best columnists. Today, we are pleased to present this commentary by San Antonio Express-News columnist Jonathan Gurwitz.

A moral imperative. A noble struggle against greedy corporate interests. A costly problem that particularly afflicts poor families, exacerbates unemployment, reduces productivity and undermines the national economy. A solution so virtuous it requires a universal mandate.

Health care reform? No. Prohibition.

The cost of health care and difficulties obtaining health insurance create predicaments no less serious than the abuse of alcohol. The issue is whether the proposed solution isn’t worse than the problem.

Supporters of the $938 billion effort to make over — if not take over — one-sixth of the U.S. economy like to point to Medicare and Social Security or even the Civil Rights Act of 1964 as its legislative precedents. Set aside for a moment that those historic measures were passed with strong bipartisan support. A majority of Republicans voted for Social Security, a near majority voted for Medicare and a significantly higher proportion of Republicans supported the Civil Rights Act than Democrats.

What the monstrosity known as Obamacare and the enduring drive to nationalize the health care system most resemble is the temperance movement. Members of the current crusade, like the one a century ago, believe they have a monopoly on wisdom. Moral certainty and an infallible faith in government guide their actions.

“Why did so many sick people follow Jesus to get healed?” asked the Rev. Susan Brooks Thistlethwaite, a senior fellow at the Center for American Progress, on the Washington Post’s “On Faith” blog. “Because the oppressive Roman Empire had reduced them to poverty and they had no health care.”

Right. If only poor Judeans had access to imperial blood-lettings and leeches, they might have abstained from those futile revolts and their messianic priggishness.

Carrie Nation with her Bible railed against the brewers of her day with no less righteousness than President Barack Obama and his Capitol Hill hatchet wielders have gone after insurance companies. Change a few of Nation’s words, and you could be reading a presidential stump speech. “Get out of the way,” she wrote in her autobiographical account of a saloon smashing in Kiowa, Kan. “I don’t want to strike you, but I am going to break tip this den of vice.”

But here the similarities end. The resolution containing the language of the 18th Amendment passed both houses of Congress with enormous bipartisan majorities. Rather than challenging Prohibition’s legality, 36 of 48 states ratified the amendment.

There’s one other significant difference. Prohibition’s universal mandate was, indeed, universal. There were no teetotaling exemptions or loopholes.

Republicans were successful in forcing changes in the health care bill that require members of Congress and most staff members to obtain health insurance though the measure’s state-run exchanges. But Politico reports a little-noticed provision in the new law appears, according to the Congressional Research Service, to exempt House and Senate leadership staff members and committee staffers.

Democrats also beat back GOP efforts that would have required members of the executive branch — including President Obama, Vice President Joe Biden and Cabinet members — to use the Obamacare exchanges. If this incarnation of health care reform is so saintly, why shouldn’t the pious few who created it and wrote it into law also share in its blessings?

Republicans hope a popular backlash will help them repeal Obamacare next year and replace it with something better. Perhaps. Another lesson of Prohibition is that all the unforeseen and unintended consequences of the 18th Amendment didn’t immediately become apparent. It took nearly 15 long, dry years before the 21st Amendment finally undid the godly work of temperance reformers.